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From: Alexander (
Subject:         Re: Persimmon and bloating/constipation
Date: November 4, 2013 at 4:28 pm PST

In Reply to: Re: Persimmon and bloating/constipation posted by Dr. Doug Graham on November 2, 2013 at 12:02 pm:

Thank you.

"Phytobezoars are the most common type of bezoars, composed of
vegetable matters such as celery, pumpkin, grape skins, prunes,
raisins, and most notably, persimmon (1)."

"Foods like persimmon contain large amounts of nondigestible dietary
fiber such as cellulose, hemicelluose, lignin and tannin. The
persimmon is characterized by its high level of tannic acid (tannins)
(4). Tannins in high concentrations form a coagulum when exposed to
gastric acid. When sufficient quantity of persimmon fruit accumulates,
phytobezoars may develop (5). Benharroch et al. (6) reported that
while ingestion of persimmon carried a 9.8-fold risk of bezoar
development, ingestion of the unpeeled fruit increased the risk of this
complication 56 times over that of age and sex-matched controls.
After diagnosis and localization of the bezoar, treatment involves
removal and prevention of recurrence."

"Bezoars are usually found in the stomach, but they may also pass into
the small bowel [3]. Small bowel bezoars are very rare and may cause
acute abdomen due to obstruction [4]. The associated clinical signs
and symptoms include vomiting, nausea, abdominal pain, fever, and
elevated leukocyte count [5]. Bezoars are concretions of fruit and
vegetable fiber in the alimentary tract [6]. Other predisposing factors
are ingestion of high-fiber foods [7]. The patientís favorite food was
persimmon. Overeating persimmons causes gastric bezoars [8].
Persimmon bezoars might therefore have caused small bowel

What is your take on this? Have you ever encountered this sort of cases
? I'am really curious to hear your opinion.

What is puzzling about these studies is that they barely give any
detailed history on patient's dietary habits. I wonder if this has to do
with impaired digestion or what other factors are involved which result
in bezoars being formed.

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